Coronary artery bypass surgery CT angiography

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Coronary Artery Bypass Surgery Microchapters

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Patient Information

Overview

Pathophysiology

Saphenous Vein Graft Disease
Other Non-Atherosclerotic Saphenous Vein Graft Diseases

Indications for CABG

Prognosis

Diagnosis

Imaging in the Patient Undergoing CABG

Chest X Ray

Angiography

CT Angiography
MRI Angiography

Trans-Esophageal Echocardiography

Treatment

Goals of Treatment

Perioperative Management

Perioperative Monitoring

Electrocardiographic Monitoring
Pulmonary Artery Catheterization
Central Nervous System Monitoring

Surgical Procedure

Anesthetic Considerations
Intervention in left main coronary artery disease
The Traditional Coronary Artery Bypass Grafting Procedure (Simplified)
Minimally Invasive CABG
Hybrid coronary revascularization
Conduits Used for Bypass
Videos on Spahenous Vein Graft Harvesting
Videos on Coronary Artery Bypass Surgery

Post-Operative Care and Complications

Recommendation for Duration of DAPT in Patients With ACS Treated With CABG

Special Scenarios

Anomalous Coronary Arteries
COPD/Respiratory Insufficiency
Existing Renal Disease
Concomitant Valvular Disease
Previous Cardiac Surgery
Menopause
Carotid Disease evaluation before surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-in-Chief: Cafer Zorkun, M.D., Ph.D. [2], Mohammed A. Sbeih, M.D. [3]

CT angiography

16 slice CT angiography

16 slice CTA has been used to assess the patency and obstruction of SVGs. Motion artifacts can make it more difficult to assess the right coronary artery. When coronary angiography is used as the gold-standard, the sensitivity to detect stenoses has ranged from 85.7-100% and the specificity has ranged from 94-100%. When the endpoint is SVG occlusion, the sensitivity (100%) and specificity (98-100%) are higher.[1][2][3][4][5][6][7][8] It should be noted that approximately 13% of patients will have non-cardiac findings on the CT scan (e.g. cancer, pulmonary embolism) that are actionable, so the reader should be aware of and competent to diagnose these findings.[9]

64 slice CT angiography

There are case reports of 64 slice CT being used in the assessment of SVG patency.[10]

References

  1. Martuscelli E, Romagnoli A, D'Eliseo A, Tomassini M, Razzini C, Sperandio M, Simonetti G, Romeo F, Mehta JL (2004). "Evaluation of venous and arterial conduit patency by 16-slice spiral computed tomography". Circulation. 110 (20): 3234–8. doi:10.1161/01.CIR.0000147277.52036.07. PMID 15533862. Retrieved 2010-07-23. Unknown parameter |month= ignored (help)
  2. Anders K, Baum U, Schmid M, Ropers D, Schmid A, Pohle K, Daniel WG, Bautz W, Achenbach S (2006). "Coronary artery bypass graft (CABG) patency: assessment with high-resolution submillimeter 16-slice multidetector-row computed tomography (MDCT) versus coronary angiography". Eur J Radiol. 57 (3): 336–44. doi:10.1016/j.ejrad.2005.12.018. PMID 16446072. Retrieved 2010-07-23. Unknown parameter |month= ignored (help)
  3. Uva MS, Matias F, Mesquita A, Costa R, Baú J, Pedro A, Magalhães MP (2008). "Sixteen-slice multidetector computed tomography for graft patency evaluation after coronary artery bypass surgery". J Card Surg. 23 (1): 17–22. doi:10.1111/j.1540-8191.2007.00479.x. PMID 18290881. Retrieved 2010-07-23.
  4. McKay CR, Brundage BH, Ullyot DJ, Turley K, Lipton MJ, Ebert PA (1983). "Evaluation of early postoperative coronary artery bypass graft patency by contrast-enhanced computed tomography". J. Am. Coll. Cardiol. 2 (2): 312–7. PMID 6602823. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)
  5. Yamamoto M, Kimura F, Niinami H, Suda Y, Ueno E, Takeuchi Y (2006). "Noninvasive assessment of off-pump coronary artery bypass surgery by 16-channel multidetector-row computed tomography". Ann. Thorac. Surg. 81 (3): 820–7. doi:10.1016/j.athoracsur.2005.08.069. PMID 16488679. Retrieved 2010-07-23. Unknown parameter |month= ignored (help)
  6. Salm LP, Bax JJ, Jukema JW, Schuijf JD, Vliegen HW, Lamb HJ, van der Wall EE, de Roos A (2005). "Comprehensive assessment of patients after coronary artery bypass grafting by 16-detector-row computed tomography". Am. Heart J. 150 (4): 775–81. doi:10.1016/j.ahj.2004.11.029. PMID 16209981. Retrieved 2010-07-23. Unknown parameter |month= ignored (help)
  7. Chiurlia E, Menozzi M, Ratti C, Romagnoli R, Modena MG (2005). "Follow-up of coronary artery bypass graft patency by multislice computed tomography". Am. J. Cardiol. 95 (9): 1094–7. doi:10.1016/j.amjcard.2004.12.067. PMID 15842980. Retrieved 2010-07-23. Unknown parameter |month= ignored (help)
  8. Schlosser T, Konorza T, Hunold P, Kühl H, Schmermund A, Barkhausen J (2004). "Noninvasive visualization of coronary artery bypass grafts using 16-detector row computed tomography". J. Am. Coll. Cardiol. 44 (6): 1224–9. doi:10.1016/j.jacc.2003.09.075. PMID 15364323. Retrieved 2010-07-23. Unknown parameter |month= ignored (help)
  9. Mueller J, Jeudy J, Poston R, White CS (2007). "Cardiac CT angiography after coronary bypass surgery: prevalence of incidental findings". AJR Am J Roentgenol. 189 (2): 414–9. doi:10.2214/AJR.06.0736. PMID 17646469. Retrieved 2010-07-23. Unknown parameter |month= ignored (help)
  10. Peterman MA, Hamman BL, Schussler JM (2007). "64-Slice CT angiography of saphenous vein graft anastomoses fashioned with interrupted nitinol clips". Ann. Thorac. Surg. 83 (3): 1204. doi:10.1016/j.athoracsur.2006.02.084. PMID 17307500. Retrieved 2010-07-23. Unknown parameter |month= ignored (help)



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